Japanese encephalitis - including symptoms, treatment and prevention

Japanese encephalitis is a rare but serious disease caused by the Japanese encephalitis virus.

 It is spread to humans by infected mosquitoes.

Japanese encephalitis is a notifiable condition1

How Japanese encephalitis virus is spread

The Japanese encephalitis virus is transmitted to humans through bites from Culex mosquitoes, which have been infected with Japanese encephalitis virus. Culex mosquitoes are commonly found in South Australia. The virus exists in a transmission cycle between mosquitoes, pigs and/or water birds.

Pigs are an important host for the virus. The virus can occur at high levels in their blood for 4-6 days. Mosquitoes that feed on infected pigs during this period can become infected with the virus and then transmit it to humans.

It cannot be transmitted by eating meat of infected animals. It cannot be spread from person to person.

Until recently, the risk for Japanese encephalitis virus infection for people living in Australia was only through overseas travel, or rarely by travel/residence in the far north of Australia. However, recently there have been cases acquired locally for the first time.

Signs and symptoms

Most people with Japanese encephalitis virus infection do not experience any illness. There may be mild symptoms such as fever and headache.

A small proportion will have encephalitis (inflammation of the brain). This may begin with symptoms such as tiredness, fever and headache, nausea, vomiting, or diarrhoea. Confusion, unusual behaviour, sleepiness, seizures, weakness, and abnormal movements may develop. Encephalitis can cause permanent damage to the nervous system or death.

Diagnosis of Japanese encephalitis virus

Diagnosis is usually made by a blood test or sample from the spinal fluid. If you have been infected, you do not put others at risk.

If you have symptoms consistent with Japanese encephalitis, seek medical attention.

If you have any severe signs such as headache, vomiting, confusion, paralysis or seizures you should call 000 immediately.

Incubation period

(Time between becoming infected and developing symptoms)

Symptoms (if they are to occur) usually develop 5 to 15 days after being bitten by infected mosquitoes.

Treatment for Japanese encephalitis virus

There is no specific treatment for infection with Japanese encephalitis virus. Serious illness with encephalitis requires management in hospital.

Prevention of Japanese encephalitis virus

  • People should take steps to limit their exposure to mosquitoes.  There are simple steps to protect themselves and their families against mosquito-borne diseases. For more information on how to protect yourself, see  Fight the Bite.
  • Exclusion from childcare, preschool, school or work is not necessary.
  • All people who work with potentially infected animals or work in areas in which infected mosquitos may be present should wear appropriate personal protective equipment (PPE). The PPE should be chosen based on the assessed level of risk and the task.

Immunisation

Japanese encephalitis virus vaccination is recommended for persons at highest risk of infection, including certain occupations. SA Health is responding to the current Japanese encephalitis outbreak by providing funded vaccines to priority groups as advised by the Communicable Diseases Network Australia. Information on Japanese encephalitis vaccines and priority groups can be found here: https://www.health.gov.au/health-alerts/japanese-encephalitis-virus-jev/vaccines. These groups are being identified and contacted through industry communication channels.

People not eligible for funded vaccines as part of this response are referred to the Fight the Bite information for other methods of protecting themselves from mosquito-borne diseases.

Vaccination for the Japanese encephalitis virus is also recommended for travellers spending one month or more in rural areas of countries with a high-risk for Japanese encephalitis.

There are currently two Japanese encephalitis vaccines available in Australia, Imojev and JEspect. For more information on these vaccines please refer to the Japanese Encephalitis Immunisation Program Fact Sheet.  For more detailed Japanese encephalitis vaccination advice see the Australian Immunisation Handbook and consult with your GP.

Useful links

1 – In South Australia the law requires doctors and laboratories to report some infections or diseases to SA Health. These infections or diseases are commonly referred to as 'notifiable conditions'.